• BASIC DRUG
    DISCUSSION
    Welcome to Bluelight!
    Posting Rules Bluelight Rules
    Benzo Chart Opioids Chart
    Drug Terms Need Help??
    Drugs 101 Brain & Addiction
    Tired of your habit? Struggling to cope?
    Want to regain control or get sober?
    Visit our Recovery Support Forums
  • BDD Moderators: Keif’ Richards | negrogesic

Pharmacy question - can I request a different manufacturer?

I read the PDF and it reminded me of Military training PDF classes lol. But from what I understand, this 'red flag' would typically only pertain to someone who is obtaining a script potentially illegitimately(hard to know I guess). Now.. if someone has a legitimate script from a provider for a controlled substance, and that said person preferred a certain brand, based off of historical use I don't think that should raise any concern. I say this as an opinion, I really don't think a red flag should come up, and I say this in my personal history. My doc prescribes me with 100mcg/hr Fentanyl every 48 hours, and 4mg Hydromorphone (Dilaudid ofc) 4-6 hr as needed, however i've been on that for about 4 years ish. Recently my pain has been so crazy that I had to check-in to the ER and be admitted because I couldn't do anything at home, or any functional work. Before, my pharmacy gave me the Sandoz brand, as I was on 75mcg/hr of Fentanyl, but now that i'm on the 100mcg they give me the Actavis brand which both are Generic? I think, as Duragesic is the brand name I believe.

More to my point, I much prefer the Sandoz brand for personal reasons, and much more so because they don't fall off like these Actavis ones do! The Actavis 100mcg are actually smaller proportionally, but they are the gel reservoir patches vs the matrix style that Sandoz has adopted. Anyways, meh!
 
Yes, PhantomPain, it of course is easier and not much of a problem if you are a long term patient. I do this for several of mine. But the OP said they had to switch pharmacies, so there wouldn't be a history.

There are certainly legitimate reasons for requesting one brand. I think anywhere I have worked, I had a patient who just could not get our preferred brand of fentanyl patches to stick. One of my current patients cuts his oxycodone and the brand we normally use cut poorly. But someone saying brand X doesn't work always makes me question if they are being truthful. Most pharmacists are aware certain brands are more sought after on the streets, so it is never a comfortable position dealing with such patients. Even now, I have one customer who wants only one brand of generic Percocet, and even though it has been two years, I still don't fully trust this patient isn't doing something other than just taking their meds. I have no proof, but his actions tell me something is up.
 
Had to chime in here and add my 2 cents. My son has autism and somewhat verbal) takes generic trileptal 150 mgs/2 times a day and was on the same generic for years (hard tablet w/coating) and the last 2 months the pharmacy has given a different generic (looks like an aspirin w/no coating) and I can tell through his behavior that it is not working as well. Trileptal is a antiseizure med used off label for mood swings and/or aggression in autism. I was wondering if I should call my pharmacy (mom and pop) or just call his doc and request a different generic as I don't mind generics, just this one.=D
 
Forgot to add that my son is 220 pounds and about a foot taller than me, so I am very concerned when his generics/meds are changed....8)
 
Karbon1991 said:
I got my Tramadol today. The ones I prefer with the clear tray and cold coloured caps. Made by Bristol Laboratories.

I think my pharmacy must just take whatever brand they can get their hands on first. I also think my pharmacy would think I was odd if I requested a certain brand, because as previously mentioned the regulations are in place so all brands should theoretically be the same.

Who knows. I'm happy I got my preferred brand anyway.
Click to expand...


I take generic tramadol and they were usually white and round when I got them from pharmacy. About 6 months later picked up my script and they were a different generic white/oblong and maybe it was just in my head but, these seemed stronger to me. Maybe less fillers? Who knows.
 
gonegirl said:
Had to chime in here and add my 2 cents. My son has autism and somewhat verbal) takes generic trileptal 150 mgs/2 times a day and was on the same generic for years (hard tablet w/coating) and the last 2 months the pharmacy has given a different generic (looks like an aspirin w/no coating) and I can tell through his behavior that it is not working as well. Trileptal is a antiseizure med used off label for mood swings and/or aggression in autism. I was wondering if I should call my pharmacy (mom and pop) or just call his doc and request a different generic as I don't mind generics, just this one.=D
Click to expand...

Couple things here. First, it is not a controlled drug, so other than the pharmacy potentionally losing money on a different generic, there really is no reason that this should be a problem. Many pharmacies will not take back properly dispensed drugs, as it usually is illegal to do so, but if you werent informed of the switch, you could argue that it wasnt done correctly, which normally is one of the conditions that allows drugs to be legally returned.

Seizure meds are also considered narrow therapeutic index (NTI) which means the window of blood levels between therapeutic and toxic levels is quite small. Most epilepsy specialists suggest staying on one manufacturer's drug once you start because the tiny difference among various brands could lead to subtherapeutic or toxic outcomes. You will hear people say the FDA allows a 20% range in the amount of active ingredients when determining bioequivalence. In actuality, the variabilty is usually only about 1-3%, which generally has no clinical effect, even for some NTI drugs. And the 20% range is the confidence interval limit of 85 to 125% not the actual exact measurement for each product each time it is tested. I wont say much more about that, but while the amount of active ingredient is tied to the CI limit, its not exactly the same.

Nevertheless, for patients with seizures, it still is recommended not to switch manufacturers with consent from your doctor. Even if the risk is extremely small, no one wants to see a previously seizure free patient have a seizure due to the brand of drug they were given.

Your son, thankfully, isnt using Trileptal for seizures. I am not downplaying autism or mood disorders, but the evidence for a change in manufacturer negatively affecting mental health conditions, is nearly non-existant compared to that for epilepsy. But still, I will say it again. Give him whatever you feel works best.
 
Karbon1991 said:
I agree. I suppose the placebo effect of a certain brand name has a big part to play in this. A friend of mine tells me sometimes when he takes Tramadol capsules that are in a clear tray, are bright yellow one side and a bold dark green the other. He feels they work better than, the duller coloured ones from a tray that isn't see through. This has to be purely down to placebo surely? Because IMO in the pharmaceutical manufacturing industry, 50mg of Tramadol is 50mg of Tramadol isn't it? This isn't street bashed gear were talking about here, if it were any less than 50mg I'm sure it would not be lawfully aloud to be sold as anything other than the weight it actually is. I suppose this is where higher grade/higher purity comes into play? Or perhaps all pharmaceutical manufacturers have the same purity?
Click to expand...

There are actually studies showing that the color of pills influence the placebo effects positively. It is bright and strong colors (red, gren, yellow etc.) that have positive effects.
 
Placebo is real. Anyone denying that obviously has never experienced it. But it is definitely real.
 
You absolutely can , but if you're on generic they can't give you anything but generic. Also, it helps to have a good working relationship with your pharmacy/pharmacist, as in: you never went in there and screamed at them before for something they have no real control over.
 
You must log in or register to reply here.
Top